By Abby S. Van Voorhees, MD,
August 01, 2011Our current wars have been largely invisible to the public.

While we may each have our thoughts regarding these wars, I think that they are not much a part of the national dialogue. There are no body bags seen and rare listings of men and women killed. We’ve also not been aware of much of what is happening in contemporary military medicine. It has clearly advanced past the MASH unit that I remember from my childhood TV watching. There have been so many advances in warfare from the days of two armies lining up to do battle in a field; guess we shouldn’t be surprised to realize that our military dermatologists are breaking barriers too. I think that you’ll find much to read in this month’s Dermatology World that can make us all proud of our generosity to those around us. Seems like a fitting thing to highlight sitting here on my porch on this July 4th weekend.

The first feature that I’d like everyone to read concerns the advances that are being developed and utilized for our soldiers returning from Iraq and Afghanistan. As a mother I want all soldiers to return home from battle. And while the military is doing a better and better job of just that, the injuries that sometimes accompany these soldiers can challenge the best physician. I think that you’ll be excited to learn of how derm is playing a significant role in addressing these injuries and ministering to those in need.

I also want you to be sure to find time to read the column on sentinel lymph node dissections. Melanoma is truly a cunning adversary for many of our patients. But we may finally be getting closer to understanding more about the potential role of sentinel node biopsies in their care. This month’s column highlights a recent article that is challenging the status quo. We’ve seen this kind of challenge before in other disciplines of medicine — breast cancer no longer requires a total radical mastectomy, some advocate for a watch-and-wait approach to prostate cancer…we’ll see where we wind up with melanoma, but the questioning is key. We don’t want to be putting patients through unnecessary procedures.

And if you are sitting on the sidelines thinking that derm is getting a bit mundane, then you’ll definitely want to read our piece on dermoscopy. This technique for looking at the skin has definitely expanded, making it relevant to all parts of dermatology. Who knew that I’d be thinking about substituting dermoscopy for a skin scraping when I saw that itchy patient in my office last week. She had been itching for several months, been worked up the wazoo, and was coming to me for one last thought. Those of us who have been sitting on the fence need to join the bandwagon. I’m convinced. I think that this feature might motivate you, too.

And if this month of lazy summer days has you feeling that pictures are a bit more your speed, then catch a glance of our last page with its data on the value of the AAD’s Skin Cancer Screening program. We can demonstrate that many patients who come to screenings would have never sought treatment otherwise. As a consequence we also now have data that they are diagnosed with cancers earlier. Both are good outcomes. The Academy deserves a pat on the back for this initiative.

Now I’ll get back to our national celebrations …parades, fireworks, and BBQs — all hopefully with a bit more sense of pride. I trust that you share my thoughts on this one. Certainly patriotism comes in many flavors; all are important and valuable.